Experience in laparoscopic cholecystectomy for complicated gallbladder disease

Objective To investigate the approach to laparoscopic cholecystectomy (LC) in the treatment of complicated gallbladder disease. Methods A retrospective analysis was performed on the clinical data of 81 patients with complicated gallbladder disease admitted to the Department of General Surgery in our hospital from August 2007 to November 2013, including 66 cases of acute cholecystitis, 14 cases of atrophic cholecystitis, and 1 case of Mirizzi syndrome. All laparoscopic operations were completed using the aspirating dissector and ultrasonic knife and lasted for 1. 5- 3 h. Results LC was successfully completed in 79 cases. One case had common hepatic duct injury during operation, which was treated by laparoscopic suture repair; one case had intraoperative bleeding and was converted to laparotomy; one case was suspected of having Mirizzi syndrome before operation and was converted to laparotomy after the syndrome was confirmed during operation.Conclusion Laparoscopic cholecystectomy is safe and feasible in the treatment of complicated gallbladder disease. The key to successful treatment is preoperative evaluation of this disease, intraoperative use of aspirating dissector and ultrasonic knife for dissecting the Calot triangle, antegrade resection combined with retrograde resection, and total resection combined with partial resection, which can effectively avoid intraoperative hemorrhage and bile duct injury.